Navigating Uterine Fibroid Management: Empowering Women Through Knowledge & Care
Some 50 to 75% of women who have uterine fibroids are unaware of this condition and the impact on their fertility and quality of life. Fibroid Awareness Month, observed every July, aims to raise awareness about fibroids, benign tumors that affect 7 to 8 out of 10 women by the age of 50 years. Studies show that Black women are 2-3 times more likely to develop fibroids that present at a younger age and with more significant symptoms like heavy menstrual bleeding and pelvic pain. This often necessitates a more extensive workup, and management.
There are several types of fibroids, classified by their location within the uterus—subserosal, intramural, and submucosal, each presenting unique symptoms ranging from heavy menstrual bleeding and pelvic pain to reproductive challenges. Factors such as age, genetics, hormonal fluctuations, ethnicity and possibly environmental factors influence the likelihood of developing fibroids. Initial diagnosis often begins with a detailed menstrual history and a pelvic examination to assess for an enlarged or irregularly shaped uterus. Ultrasound is the most commonly used imaging modality, while MRI offers detailed insights for complex cases or surgical planning. It’s important to differentiate fibroids from other pelvic masses like ovarian tumors or adenomyosis to tailor appropriate management.
Given the prevalence and potential complications of uterine fibroids, a thorough and multi-faceted approach to treatment is crucial. Treatment for fibroids will depend upon symptoms, size, number, location, level of pain, and the fertility plans of the patient. Medical treatment can help manage symptoms, but will not eliminate the fibroid(s) in its entirety. Surgery remains the definitive treatment option.
Women with fibroids who aim for pregnancy may benefit from preconception counseling to evaluate the need for fibroid treatment first. Educating patients about this condition and the full spectrum of treatment options empowers them to make informed choices in line with their health status and life goals. Access to support groups, counseling, and educational resources can provide emotional support and practical information, aiding women in navigating their treatment journey. Continued monitoring and follow-up care are essential for managing recurrent symptoms and evaluating the effectiveness of treatment over time.
The comprehensive management of uterine fibroids requires a personalized approach that encompasses early diagnosis, consideration of a range of treatment options, and supportive lifestyle modifications. By addressing these key areas, physicians will be able to significantly enhance the quality of life for women affected by fibroids. Treatment innovations, including newer medications, advanced radiological techniques, and less invasive surgical approaches, continue to evolve, offering hope for more effective fibroid management. Learn more about advances in Uterine Fibroid Management, Uterine Fibroid Management – American Medical Women’s Association (amwa-doc.org)
Dr. Cheruba Prabakar, OB-GYN, Minimally Invasive Gynecologist, Lamorinda Gynecology and Surgery, Lafayette, CA
Dr. Jessica Ritch, Minimally Invasive Gynecologist Florida Center for Urogynecology, Hollywood, FL
Jodi Godfrey, AMWA Deputy Director
Dr. Eliza Chin, AMWA Executive Director
References
De La Cruz, M. MD; Buchanan, E. MD; Uterine Fibroids: Diagnosis and Treatment, Am Fam Physician. 2017;95(2):100-107.
Orellana, M., DSouza, K.N., Yap, J.Q. et al. : “In our community, we normalize pain”: discussions around menstruation and uterine fibroids with Black women and Latinas. BMC Women’s Health 2024, 233.
Donnez, J., Dolmans, M.; Uterine fibroid management: from the present to the future, 2016 Nov; 22(6): 665–686.
Farris, M., Bastianelli, C., Rosato, E., Brosens, I., Benagiano, G.: Uterine fibroids: an update on current and emerging medical treatment options, Ther Clin Risk Manag. 2019; 15: 157–178.
Tran A.P., Al Naber J., Tambor E.S., Myers E.R. Addressing heterogenous outcomes in uterine fibroid research: a call to action. Am J Obstet Gynecol. 2020; 223: 75.e1-75.e5